causes and management. of Non-alcoholic fatty liver disease (NAFLD)

Clinical answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 10 August 2025Updated: 10 August 2025 Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Causes of non-alcoholic fatty liver disease (NAFLD): NAFLD is primarily caused by metabolic risk factors such as obesity, insulin resistance, type 2 diabetes, and metabolic syndrome .

Other contributing factors include poor diet, physical inactivity, and possibly genetic predisposition .

Management options for NAFLD: The main management approach involves lifestyle modifications, including diet, physical activity, and gradual weight loss, aiming for a 5-10% weight reduction over 6 months .

Adopting a Mediterranean diet and reducing sugar-sweetened beverages are recommended .

Moderate intensity exercise for 150-200 minutes per week, combining aerobic activity with diet, is most effective .

Management also includes controlling associated conditions such as hypertension, hyperlipidaemia, and type 2 diabetes .

Alcohol intake should be within national recommended limits, as alcohol consumption in moderation might be protective against NAFLD .

People with NAFLD should continue statin therapy if prescribed, as statins are safe and may improve liver histology .

Pharmacological treatments like pioglitazone and vitamin E are considered in secondary care for advanced fibrosis, but are off-label and require specialist management .

Educational content only. Always verify information and use clinical judgement.